Key Questions by Dagmara Scalise

As you discuss your symptoms with your health-care provider, may develop. For your initial meeting, however, here are of the most common questions about PMDD and some preliminary answers.

I’m embarrassed to seek treatment for my premenstrual Is this normal?

Unfortunately, yes. A great many women don't seek treatment because they are embarrassed about having a premenstrual illness or a mood disorder. Society tends to stigmatize people with mental illness, in part because of so many misconceptions about what causes it and also because people often assume that mental illness causes people to be violent. In addition, many people in our society remain squeamish about anything having to do with the menstrual cycle. However, don’t let embarrassment stand in the way of getting help for your symptoms. PMDD is a real and treatable illness.

How does PMDD impact my family?

Mood symptoms, such as depression, which predominate PMDD, have a pronounced effect on your relationships with others, including spouses and children. A woman in the grips of a mood disorder has trouble relating to and interacting with her spouse and her children. As a result, spouses tend to get angry while children and adolescents feel insecure and develop behavior problems.

I have very severe mood symptoms. Should I go see a psychiatrist or should I stick with my gynecologist?

That depends. If you have not yet spoken with your doctor, either your gynecologist or your primary care provider, about your PMDD, you might want to start there. He or she will be able to help you assess your symptoms and suggest a course of action that does not rely on drugs. He or she can also prescribe drugs if necessary. However, if you suspect you might have depression, bipolar illness, or another mood disorder, you might be better off with a psychiatrist. Psychiatrists are also more experienced in distinguishing and treating depressive disorder than your primary care physician or OB/GYN. Finally, a psychiatrist is likely to treat PMDD with different drugs than your OB-GYN would.

May I try alternative medicine to treat my PMDD or do I have take SSRIs?

Any time you have significant mood symptoms, you should see your physician for assessment and possible treatment. However, if you are strongly opposed to standard medicine and are comfortable using herbal products (which are not subject to FDA oversight and scrutiny), you may want to try taking chasteberry.

A 2001 German study of 178 women found that a 20-milligram tablet daily of Agnus castus, the active fruit extract in chasteberry, helped alleviate premenstrual symptoms better than a placebo. The women in the study received daily either a 20-milligram tablet or a Researchers found that 52 percent of the women receiving Agnus reported improvement, compared with 24 percent of the group. This result is similar to that of improvements reported for SSRIs.

What are the side effects of SSRIs?

The side effects of these medications include nervousness, sexual dysfunction, restlessness, nausea, and diarrhea. reason, most doctors prescribe a low dose at first and then increase slowly as needed. This is also why it’s important to change medications gradually if necessary. If you experience significant side effects your medication, don’t discontinue it without your doctor’s supervision.

What if I do nothing? Does PMDD end on its own?

If you wait long enough, menopause will eventually put an your PMDD symptoms. But depending on your age, you may a long, long time. Finally, your PMDD may actually be a mood disorder or may be complicated by another mood disorder. this case, your symptoms will not spontaneously end at menopause but will continue to affect your life.